Litigation


NPDB Reporting Protected by Law in Some Cases, Gray Areas Problematic
July 8, 2021 | Rivkin Rounds Staff | Hospitals | Legislation and Public Policy | Litigation
An article in the July issue of Hospital Peer Review, “NPDB Reporting Protected by Law in Some Cases, Gray Areas Problematic,” discussed hospitals’ obligations to report doctors to the National Practitioner Data Bank (NPDB) and their protection against liability for doing so. Rivkin Radler’s Chris Kutner was quoted extensively in the article. “In the matters …
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Compounding the Fraud: Questionable Billing by Pharmacies
July 6, 2021 | Rivkin Rounds Staff | FDA | False Claims Act | Fraud and Abuse | Litigation | Medicare and Medicaid | Pharmaceuticals
Rivkin Radler partners Evan Krinick and Michael Sirignano authored an article, “Compounding the Fraud: Questionable Billing by Pharmacies,” in the July 6 issue of the New York Law Journal. The article discussed the U.S. Department of Justice’s continued concern over fraudulent claims for reimbursement to federal healthcare programs for compounded prescription drugs. …
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Sham Speaker Fees Lead to Jail Term
June 17, 2021 | Eric D. Fader | False Claims Act | Fraud and Abuse | Litigation | Pharmaceuticals
On June 16, Jeffrey Goldstein, a former Manhattan physician, was sentenced to 57 months in prison for taking $196,000 in kickbacks from Insys Therapeutics, a defunct Arizona-based opioid manufacturer. Goldstein pled guilty to conspiracy in 2019 for accepting purported “speaker fees” from Insys in 2013-15 to prescribe the company’s fentanyl spray, Subsys. Goldstein was one …
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OCR’s HIPAA Right of Access Initiative Continues
June 11, 2021 | Eric D. Fader | Electronic Health Records | HIPAA | Legislation and Public Policy | Litigation
The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) has pursued its HIPAA Right of Access Initiative since 2019. OCR’s 19th settlement under the initiative, with The Diabetes, Endocrinology & Lipidology Center, Inc. (DELC), curiously resulted in only a $5,000 fine. The West Virginia provider treats patients who have endocrine disorders. …
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How to Avoid False Claims Act Violations
June 1, 2021 | Rivkin Rounds Staff | COVID-19 | Employer/Employee | False Claims Act | Fraud and Abuse | Hospitals | Litigation | Medicare and Medicaid | Telehealth
On June 10, Rivkin Radler partner Bob Iseman will discuss False Claims Act (FCA) compliance in the next installment of the firm’s Healthcare Compliance Lunch & Learn series, “How to avoid False Claims Act violations.” The webinar registration page is here. The FCA applies to any person or entity doing business with the federal government. Every …
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DOJ Announces COVID-19 Fraud Takedown
May 27, 2021 | Eric D. Fader | COVID-19 | Fraud and Abuse | Home Health | Litigation | Medicare and Medicaid | Telehealth
On May 26, the U.S. Department of Justice (DOJ) announced criminal charges against 14 defendants in six states for participation in healthcare fraud schemes related to the COVID-19 pandemic. The coordinated takedown involved fraudulent claims for laboratory testing, telemedicine fraud, pharmacy fraud, payment of kickbacks for referrals, and alleged misappropriation of COVID-19 Provider Relief Fund …
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EHR Company in $3.8M Kickback Settlement
May 13, 2021 | Eric D. Fader | Electronic Health Records | False Claims Act | Fraud and Abuse | Litigation | Medicare and Medicaid
The U.S. Department of Justice recently announced that CareCloud Health, a Florida-based developer of electronic health records software, agreed to pay $3.8 million to resolve a whistleblower’s allegations that it paid illegal kickbacks to generate sales of its products. CareCloud’s marketing referral program called the “Champions Program” allegedly violated the federal Anti-Kickback Statute (AKS) and …
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HIPAA Hot Topics: Right to Access, Third Party Authorizations, and Navigating Difficult Denials
April 23, 2021 | Rivkin Rounds Staff | Electronic Health Records | HIPAA | Legislation and Public Policy | Litigation | Private Insurers
Rivkin Radler’s Ashley Algazi and Eric Fader will be presenting at the Health Care Compliance Association’s New York Regional Healthcare Compliance Conference on May 7. The conference will be held virtually via Zoom. The presentation, titled “HIPAA Hot Topics: Right to Access, Third Party Authorizations, and Navigating Difficult Denials,” will include the following topics: Overview …
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Insurance Fraud Scheme Lands Chiropractor in Prison
April 16, 2021 | Margarita Christoforou | Fraud and Abuse | Litigation | Medicare and Medicaid
The U.S. Department of Justice (DOJ) announced on April 13 that James Spina, a licensed chiropractor and the unlawful operator of Dolson Avenue Medical, P.C. (DAM), was sentenced to nine years in prison and three years of post-release supervision. DAM, a multi-disciplinary medical practice in Middletown, New York, purported to provide a variety of pain …
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Bristol-Myers Squibb Settles MDRP Underpayment Claim for $75 Million
April 14, 2021 | Eric D. Fader | False Claims Act | Litigation | Medicare and Medicaid | Pharmaceuticals
The U.S. Department of Justice recently announced that Bristol-Myers Squibb (BMS) agreed to pay $75 million, plus interest, to resolve allegations that it knowingly underpaid rebates owed under the Medicaid Drug Rebate Program (MDRP). Of that total, $41 million plus interest will be paid to the federal government and the remainder to various state Medicaid …
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